高尿酸血症与急性缺血性卒中患者转归的相关性

Correlation between hyperuricemia and outcome in patients with acute ischemic stroke

目的:探讨高尿酸血症与急性缺血性卒中患者转归的关系。方法:回顾性纳入2020年1月至2020年9月期间上海中医药大学附属普陀医院神经内科收治的急性缺血性卒中患者。在发病3个月后应用改良Rankin量表评估临床转归,≤2分为转归良好,>2分为转归不良。对转归良好组与转归不良组人口统计学和基线特征进行比较,然后进一步采用多变量logistic回归分析确定转归的独立影响因素。结果:共纳入210例患者,年龄(69.87±6.62)岁;男性125例(59.52%),女性85例(40.48%);基线中位美国国立卫生研究院量表(National Institutes of Health Stroke Scale,NIHSS)评分为4分;169例(80.48%)血尿酸水平正常,41例(19.52%)存在高尿酸血症;120例(57.14%)转归良好,90例(42.86%)转归不良。转归不良组糖尿病、既往卒中或短暂性脑缺血发作史、高尿酸血症的患者构成比以及血糖、血清尿酸和基线NIHSS评分显著高于转归良好组(P均<0.05)。多变量logistic回归分析显示,糖尿病[优势比(odds ratio,OR)2.735,95%置信区间(confidence interval,CI)1.461~5.121;P=0.002)、高尿酸血症(OR 2.400,95%CI 1.102~5.228;P=0.027)和基线NIHSS评分较高(OR 1.233,95%CI 1.118~1.360;P<0.001)为急性缺血性卒中患者转归不良的独立危险因素。结论:高尿酸血症是急性缺血性卒中患者转归不良的独立危险因素。

Objective To investigate the relationship between hyperuricemia and outcome in patients with acute ischemic stroke.Methods Patients with acute ischemic stroke admitted to Department of Neurology,Putuo Hospital,Shanghai University of Tranditional Chinese Medicine between January 2020 and September 2020 were enrolled retrospectively.The modified Rankin Scale(mRS)score was used to evaluate the clinical outcome 3 months after the onset.≤2 was considered as good outcome,and>2 was considered as poor outcome.The demography and baseline characteristics were compared between the good outcome group and the poor outcome group.Multivariate logistic regression analysis was used to determine the independent influencing factors of the outcome.Results A total of 210 patients were included,their age was 69.87±62.62 years.There were 125 males(59.52%)and 85 females(40.48%).The baseline median National Institutes of Health Stroke Scale(NIHSS)score was 4.The serum uric acid level in 169 patients(80.48%)was normal and 41(19.52%)had hyperuricemia;120 patients(57.14%)had a good outcome,and 90(42.86%)had a poor outcome.Blood glucose level,serum uric acid level,baseline NIHSS score and the proportions of diabetes mellitus,history of stroke or transient ischemic attack,hyperuricemia in the poor outcome group were significantly higher than those in the good outcome group(all P<0.05).Multivariate logistic regression analysis showed that diabetes mellitus(odds ratio[OR]2.735,95%confidence interval[CI]1.461-5.121;P=0.002),hyperuricemia(OR 2.400,95%CI 1.102-5.228;P=0.027),and higher baseline NIHSS score(OR 1.233,95%CI 1.118-1.360;P<0.001)were the independent risk factors for poor outcome in patient with acute ischemic stroke.Conclusion Hyperuricemia is an independent risk factor for poor outcome in patients with acute ischemic stroke.